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A Trump trade deal after a no deal Brexit would be the NHS’ “death knell”, campaigners have warned.

US pharmaceutical firms are intent on ending health service agreements that keep the cost of drugs and medical products down as part of a trade deal with UK that the Tory government is desperately seeking.

The Office of the US Trade Representatives has released a document spelling out American objectives for a post-Brexit trade agreement with the UK.

As well as wanting “full market access for US products”, American pharmaceutical companies want an end to price controls on NHS drugs, which they describe as “unreasonable”.

Without the caps, the NHS could be forced to pay American prices – potentially resulting in costs for operations rising by up to six times and the price of some medicines increasing 20 fold.

For example, Nexium, an acid reflux drug, costs 66p a pill in the UK, while in America the price rockets to £7.40.

Hip replacements in the US can cost as much £37,000, compared to just £7,500 in Britain.

Co-chair of campaign group Keep Our NHS Public, Dr Tony O’Sullivan, said promises from Boris Johnson that the NHS would not be offered up as part of a trade deal with the US are worthless.

He told the Mirror, “The verbal assurances from Johnson that the NHS won’t be in trade deals are nothing more than hot air.

“We’ve had false assurances that the Government isn’t privatising the NHS when it is already.

“A trade deal with the US would be the death knell of the NHS and would nail down the market in the NHS for ever.”

Unite assistant general secretary Steve Turner said Johnson and other hard Brexiteers are intent on toadying up to the Trump regime at the expense of the British public.

“Their sycophantic ‘Make Britain Great Again’ ideology cares nothing for the people of this country but is all about unleashing laissez-faire capitalism on steroids,” Turner said.

“If they get their way we would see the NHS destroyed from the inside, our labour market become even more dominated by low paid insecure work, our food and environmental standards plummet and our economy repurposed to even better serve the interests of the super rich.”